Factors associated with chronic back pain in adults in Brazil

Malta, Deborah Carvalho; Oliveira, Max Moura de; Andrade, Silvânia Suely Caribé de Araújo; Caiaffa, Waleska Teixeira; Souza, Maria de Fatima Marinho de; Bernal, Regina Tomie Ivata

doi:10.1590/S1518-8787.2017051000052

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Brasil

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Sumário

Original Articles • Rev. Saúde Pública 51 (suppl 1) • 2017 • https://doi.org/10.1590/S1518-8787.2017051000052 copy

Factors associated with chronic back pain in adults in Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To identify associations of chronic back pain with sociodemographic characteristics, lifestyles, body mass index, self-reported chronic diseases and health assessment, according to sex.

METHODS

We analyzed data from the 2013 National Health Survey, estimated the prevalence and their respective 95% confidence intervals (95%CI) of chronic back pain, according to selected variables and performed adjustment by age and education.

RESULTS

18.5% of the Brazilian population reported chronic back pain, 15.5% (95%CI 14.7–16.4) of them being men and 21.1% (95%CI 20.2–22.0) being women. The characteristics that remained associated and statistically significant (p < 0.05) after adjustment, in men, were: age group, higher in men with 65 years or older (OR_a = 6.06); low education level; living in rural area; history of smoking, high salt intake, increase in the time of heavy physical activity at work and at home; being overweight (OR_a = 1.18) or obese (OR_a = 1.26); diagnostic of hypertension (OR_a = 1.42), high cholesterol (OR_a = 1.60); and worse health assessment in comparison with very good (good [OR_a = 1.48]; regular [OR_a = 3.22]; poor [OR_a = 5.00], very poor [OR_a = 8.60]). Among women, they were: increase with age, higher among women with 55-64 years (OR_a = 3.64); low education level; history of smoking, regular candy consumption, high salt intake, heavy physical activity at work and at home and increase in the time of these activities; being overweight (OR_a = 1.23) or obese (OR_a = 1.32); diagnosis of hypertension (OR_a = 1.50), high cholesterol (OR_a = 1.84); and worse health assessment than very good (good [OR_a = 1.43]; regular [OR_a = 3.16]; poor [OR_a = 5.44], very poor [OR_a = 8.19]).

CONCLUSIONS

Our findings point out differences by sex and contribute to the knowledge of the panorama of chronic back pain, which, besides affecting individuals, generate negative socioeconomic impacts, by causing work-related disabilities and hindering everyday activities.

Adult; Low Back Pain, epidemiology; Diagnostic Self Evaluation; Risk Factors; Socioeconomic Factors; Health Surveys

Variable	Male			Female

	%^a	95%CI	p^b	%^a	95%CI	p^b
Age group (years)			< 0.01			< 0.01
18–24	5.6	4.4–6.8		10.1	8.3–12
25–34	9.9	8.6–11.2		12.7	11.4–14
35–44	14.7	13–16.3		20	18.3–21.7
45–54	21.6	19.5–23.8		26.8	24.8–28.9
55–64	22.3	19.8–24.8		30.4	27.8–32.9
65 or older	25.5	22.6–28.4		31.3	28.9–33.7
Education level			< 0.01			< 0.01
Illiterate/Some elementary or middle school	21.9	20.4–23.4		27.1	25.6–28.5
Elementary or middle school/Some high school	12.5	10.7–14.3		19.1	17.1–21.1
High school/Some higher education	10.5	9.3–11.8		16.9	15.6–18.1
Higher education degree	12	9.8–14.2		16.7	14.7–18.8
Race/skin color^c			0.6			0.02
White	15.9	14.6–17.1		22.2	20.9–23.5
Black	14.4	11.8–17		20.9	18.3–23.5
Brown	15.5	14.4–16.7		19.8	18.5–21
Area			< 0.01			0.43
Urban	14.6	13.7–15.5		20.9	20–21.9
Rural	20.7	18.7–22.8		21.9	19.6–24.3
Smoking			< 0.01			< 0.01
Non-smoker	11.8	10.8–12.8		18.5	17.6–19.5
Former smoker	23	21–24.9		30.2	27.8–32.6
Smoker	19	17.1–20.9		26.6	24.1–29.2
Abusive consumption of alcohol			0.47			0.16
No	15.6	14.8–16.5		21.2	20.2–22.1
Yes	14.7	12.5–17		17.8	13.4–22.2
Consumption of red meat with fat			0.05			0.21
Yes	16.4	15.2–17.7		20.3	18.7–21.8
No	14.9	13.9–15.9		21.4	20.3–22.4
Regular candy consumption			0.73			0.18
No	15.5	14.6–16.4		21.4	20.4–22.4
Yes	15.8	14–17.7		20.1	18.4–21.7
Regular soda consumption			< 0.01			0.01
No	16.3	15.3–17.3		21.6	20.6–22.6
Yes	13.4	11.8–15		18.9	17.2–20.7
High salt intake			0.36			0.62
No	15.4	14.5–16.3		21.1	20.2–22.1
Yes	16.3	14.4–18.3		20.6	18.5–22.7
Recommended consumption of fruits and vegetables (five or more daily servings)			0.38			< 0.01
Yes	16.5	14.2–18.7		24.1	22–26.1
No	15.4	14.5–16.3		20.4	19.5–21.4
Insufficiently physical active in the four areas			< 0.01			0.18
No	15.4	14.4–16.4		21.6	20.4–22.9
Yes	15.8	14.4–17.1		20.6	19.4–21.7
Heavy activity at work			< 0.01			< 0.01
No	11.7	10.7–12.7		17.6	16.3–18.8
Yes	18.7	17–20.5		27.7	24.9–30.6
Time (minutes) of heavy physical activity at work in a normal day			< 0.01			< 0.01
0	14.9	14–15.7		19.8	18.8–20.7
1–149	17.9	14.1–21.8		23.5	20–27.1
≥ 150	25	20.9–29		25.9	23.9–27.9
Heavy physical activity at home			< 0.01			< 0.01
No	14.9	14–15.7		19.8	18.8–20.7
Yes	22	19.2–24.8		25.4	23.5–27.2
Time (minutes) of heavy physical activity at home in a normal day			< 0.01			< 0.01
0	14.5	13.5–15.4		20.4	19.5–21.4
1–149	16	11.8–20.2		27.8	21.5–34.1
≥ 150	19.1	17.3–21		27.7	24.5–30.9
Watching TV for more than three hours			0.15			0.76
No	15.9	14.9–16.9		21.2	20.1–22.2
Yes	14.6	13.1–16.1		20.9	19.5–22.3
Classification by BMI^d			0.09			< 0.01
Normal	15.4	14–16.8		18	16.6–19.3
Overweight	16.3	14.9–17.8		23.5	21.6–25.4
Obesity	18.3	15.9–20.8		25.6	23.3–28
Hypertension			< 0.01			< 0.01
No	13.5	12.7–14.4		17.5	16.6–18.4
Yes	24.6	22.3–26.8		32.3	30.4–34.2
Diabetes			< 0.01			< 0.01
No	15.2	14.4–16.1		20.3	19.4–21.3
Yes	21.1	17.3–24.9		30.8	27.5–34
Cholesterol			< 0.01			< 0.01
No	14.5	13.6–15.3		18.4	17.5–19.3
Yes	25.7	22.7–28.7		36.1	33.7–38.5
Health assessment			0.68			< 0.01
Very good	6.8	5.4–8.3		10.2	8.4–11.9
Good	11.2	10.3–12.2		14.6	13.6–15.6
Regular	25.6	23.7–27.5		30.4	28.7–32.1
Poor	37.5	32.7–42.2		45	41.1–48.9
Very poor	49.6	39.8–59.4		52.5	45.1–59.9
Total	15.5	14.7–16.4		21.1	20.2–22

Variable	OR_crude	95%CI	OR_a^b	95%CI
Age group (years)
18–24	1		1
25–34	1.84	1.41–2.42	1.87	1.42–2.46
35–44	2.9	2.25–3.73	2.73	2.11–3.53
45–54	4.65	3.59–6.02	4.2	3.22–5.47
55–64	4.83	3.68–6.33	4.16	3.16–5.49
65 or older	5.78	4.39–7.62	4.57	3.45–6.06
Education level
Illiterate/Some elementary or middle school	1		1
Elementary or middle school/Some high school	0.51	0.42–0.61	0.7	0.58–0.85
High school/Some higher education	0.42	0.36–0.49	0.59	0.51–0.7
Higher education degree	0.49	0.39–0.61	0.54	0.43–0.67
Race/skin color^c
White	1		1
Black	0.9	0.71–1.13	0.84	0.67–1.05
Brown	0.98	0.87–1.11	0.98	0.86–1.12
Area
Urban	1		1
Rural	1.53	1.32–1.76	1.26	1.08–1.46
Smoking
Non-smoker	1		1
Former smoker	2.23	1.94–2.56	1.54	1.34–1.78
Smoker	1.75	1.5–2.05	1.41	1.2–1.65
Abusive consumption of alcohol
No	1		1
Yes	0.93	0.77–1.13	1.06	0.87–1.28
Consumption of red meat with fat
Yes	1		1
No	0.89	0.79–1	0.92	0.82–1.03
Regular candy consumption
No	1		1
Yes	1.03	0.88–1.2	1.18	1–1.38
Regular soda consumption
No	1		1
Yes	0.79	0.68–0.93	1.01	0.86–1.18
High salt intake
No	1		1
Yes	1.07	0.92–1.25	1.28	1.09–1.49
Recommended consumption of fruits and vegetables (five or more daily servings)
Yes	1		1
No	0.92	0.78–1.1	0.99	0.83–1.19
Insufficiently physical active in the four areas
No	1		1
Yes	1.03	0.91–1.16	0.83	0.72–0.94
Heavy activity at work
No	1		1
Yes	1.73	1.5–2	1.65	1.41–1.92
Time (minutes) of heavy physical activity at work in a normal day
0	1		1
1–149	1.25	0.96–1.62	1.33	0.96–1.84
≥ 150	1.9	1.52–2.38	1.52	1.31–1.77
Heavy physical activity at home
No
Yes	1.61	1.36–1.92	1.6	1.33–1.92
Time (minutes) of heavy physical activity at home in a normal day
0	1		1
1–149	1.13	0.82–1.55	1.3	0.99–1.72
≥ 150	1.4	1.22–1.61	1.81	1.44–2.29
Watching TV for more than three hours
No	1		1
Yes	0.9	0.79–1.04	0.95	0.82–1.09
BMI^d
Normal	1		1
Overweight	1.15	1.01–1.31	1.18	1.02–1.36
Obesity	1.32	1.11–1.58	1.26	1.05–1.53
Hypertension
No	1		1
Yes	2.08	1.82–2.39	1.42	1.23–1.65
Diabetes
No	1		1
Yes	1.49	1.18–1.88	0.98	0.77–1.23
Cholesterol
No	1		1
Yes	2.04	1.72–2.42	1.6	1.34–1.92
Health assessment
Very good	1		1
Good	1.73	1.36–2.19	1.48	1.16–1.89
Regular	4.68	3.64–6.02	3.22	2.49–4.16
Poor	8.16	6.04–11.01	5	3.67–6.81
Very poor	13.38	8.52–21.02	8.6	5.51–13.44

Variable	OR_crude	95%CI	OR_a^b	95%CI
Age group (years)
18–24	1		1
25–34	1.29	1.03–1.62	1.31	1.04–1.65
35–44	2.22	1.76–2.79	2.2	1.74–2.78
45–54	3.25	2.61–4.06	3.11	2.48–3.91
55–64	3.86	3.07–4.87	3.64	2.86–4.62
65 or older	4.04	3.23–5.05	3.62	2.86–4.59
Education level
Illiterate/Some elementary or middle school	1		1
Elementary or middle school/Some high school	0.64	0.55–0.74	0.9	0.77–1.04
High school/Some higher education	0.55	0.49–0.61	0.82	0.73–0.93
Higher education degree	0.54	0.46–0.64	0.68	0.58–0.8
Race/skin color^c
White	1		1
Black	0.93	0.78–1.1	0.88	0.74–1.06
Brown	0.86	0.78–0.95	0.88	0.79–0.97
Area
Urban	1		1
Rural	1.06	0.92–1.23	1	0.85–1.17
Smoking
Non-smoker	1		1
Former smoker	1.9	1.68–2.15	1.46	1.28–1.65
Smoker	1.59	1.38–1.84	1.32	1.13–1.53
Abusive consumption of alcohol
No	1		1
Yes	0.81	0.6–1.09	1.04	0.76–1.43
Consumption of red meat with fat
Yes	1		1
No	1.07	0.96–1.19	1.05	0.94–1.17
Regular candy consumption
No	1		1
Yes	0.92	0.82–1.04	1.14	1.01–1.29
Regular soda consumption
No	1		1
Yes	0.84	0.75–0.96	1.05	0.92–1.19
High salt intake
No	1		1
Yes	0.97	0.84–1.11	1.18	1.02–1.36
Recommended consumption of fruits and vegetables (five or more daily servings)
Yes	1		1
No	0.81	0.72–0.91	0.85	0.75–0.96
Insufficiently physical active in the four areas
No	1		1
Yes	0.94	0.86–1.03	0.84	0.76–0.92
Heavy activity at work
No	1		1
Yes	1.8	1.54–2.11	1.69	1.44–2
Time (minutes) of heavy physical activity at work in a normal day
0	1		1
1–149	1.25	1.02–1.53	1.71	1.23–2.37
≥ 150	1.42	1.27–1.59	1.64	1.38–1.94
Heavy physical activity at home
No	1		1
Yes	1.38	1.24–1.54	1.48	1.32–1.66
Time (minutes) of heavy physical activity at home in a normal day
0	1		1
1–149	1.5	1.09–2.06	1.31	1.05–1.63
≥ 150	1.49	1.26–1.76	1.54	1.36–1.73
Watching TV for more than three hours
No	1		1
Yes	0.98	0.89–1.09	0.96	0.87–1.07
BMI^d
Normal	1		1
Overweight	1.28	1.13–1.44	1.23	1.09–1.39
Obesity	1.43	1.26–1.63	1.32	1.15–1.51
Hypertension
No	1		1
Yes	2.25	2.04–2.49	1.5	1.34–1.68
Diabetes
No	1		1
Yes	1.74	1.49–2.03	1.11	0.94–1.31
Cholesterol
No	1		1
Yes	2.5	2.23–2.81	1.84	1.63–2.06
Health assessment
Very good	1		1
Good	1.51	1.23–1.85	1.43	1.16–1.76
Regular	3.86	3.14–4.74	3.16	2.55–3.91
Poor	7.24	5.65–9.29	5.44	4.21–7.03
Very poor	9.78	6.89–13.87	7.19	4.95–10.44

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[1] Correspondence: Deborah Carvalho Malta. Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem – UFMG. Av. Alfredo Balena, 190. 30130-100 Belo Horizonte, MG, Brasil E-mail: dcmalta@uol.com.br